The first sign of potentially serious trouble during the birth of Brandon Hall, on Sept. 9, 2010, was the greenish tinge in the fluid when his mother’s water broke.

Meconium, an infant’s first stool, typically occurs after birth. Showing up in the amniotic fluid suggested it already had – and may have entered the lungs of the unborn baby, blocking his airways.

“When he came out, he was covered in the meconium. He was totally covered,” said Brandon’s mother, Tricia Hall. “When he took his first breath, he collapsed both lungs.”

Hall held her baby for mere seconds after his birth before he was taken away to be examined. She, her husband, Jon, and mother, Corinne Anzalone, who were there during the delivery, were soon joined by other relatives.

Then someone said the room had to be cleared.

That directive to clear the room is etched in her memory.

“The thing that will replay in my mind, and I picture so vividly: ‘Everybody has to leave the room – we need to talk to the parents,’ ” she remembered someone saying.

On a recent afternoon, a healthy, inquisitive Brandon explored brightly colored toys in the ninth floor Child Life Playroom at Women & Children’s Hospital, while his mother described his birth in Millard Fillmore Suburban Hospital and the two weeks he spent in the 64-bed neonatal intensive care unit at Children’s, the largest and most advanced unit of its kind in Western New York.

Nancy Barclay, a neonatal nurse practitioner, was on duty that day at Millard Fillmore Suburban and attended the delivery.

“I realized right after birth that Brandon was in grave circumstances – that he needed help,” Barclay said. “I knew immediately what I needed to do and how I needed to do it.”

Barclay, a member of Children’s Neonatal Transport Team, helped stabilize Brandon in the newborn nursery and arrange for him to be rushed to Children’s. She’s part of a team of 14 neonatal nurse practitioners trained in stabilization and intervention techniques who divide their time between the two hospitals and are dispatched to community hospitals to pick up critically ill infants.

“They were wonderful,” Hall said about the transport team.

Seasoned professionals, each member has decades of experience. “Each one of us has been to hundreds of deliveries over our careers,” said Barclay, who joined the team in 1985.

The team itself dates back to the 1970s. It uses a specially equipped neonatal ambulance that can carry two infants at a time.

Last year, team members – who work with pediatric respiratory therapists and, when necessary, neonatal physicians – performed 319 transports; 30 were by air.

Each of the two hospitals averages 3,000 births a year, and there’s a neonatal nurse practitioner attending approximately 40 percent of them. About 10 percent of babies require some assistance at delivery, Barclay said. And just 1 percent require extensive measures, such as resuscitation.

Brandon’s condition fell within that 1 percent.

“Brandon was very sick. There was a time when I was thinking, ‘I hope that he makes it,’ ” Barclay said.

Now Brandon is thriving, with asthma as the only long-term effect of those nightmarish first days. He’s also a doting big brother – to Justin, who celebrated his first birthday in March.

Hall praised the care and commitment of those who helped get Brandon through those dark days.